Event Abstract

Improvement of vestibulo-cerebellar function in patient with symptoms of dizziness and imbalance following chiropractic neurology treatments

  • 1 NeuroSpinal Health Center, United States
  • 2 Life University, United States

Background: A 72-years-old female presented to a chiropractic neurology clinic with a chief complaint of imbalance and dizziness and a secondary complaint of chronic neck pain with radiculopathy into her left arm. The patient had a health history of positional vertigo, light-headedness and decreased auditory ability in the left ear. Blood work, cervical x-rays and brain MRI were taken with no pathology identified. The patient reported anxiety, inability to workout, walk, drive and work by herself. Methods: The Clinical Test of Sensory Integration and Balance (CTSIB) and Fall risk test were performed on computerized dynamic posturography equipment. The test revealed a backwards displacement of center of gravity (COG) in all conditions with 2.56 average sway index. Patient had a high sway index score of 6.23 when evaluated on a perturbed surface with eyes closed. Upon neurological examination, the patient demonstrated a positive Romberg Test, Fukuda Step and Hallpike Dix Maneuver. Right facial hyposensitivity was elicited upon light touch and pin prick stimulus. Deep tendon reflexes resulted in grade +3 for bilateral biceps, triceps, patellar and achilles tendons. High frequency of square wave jerks was present during gaze holding examination. The vestibulo-ocular reflex (VOR) testing produced nystagmus bilaterally and saccades were hypermetric to the right. Pursuits testing revealed saccadic intrusions in both horizontal and vertical directions. To address the exam findings, a program of cerebellar and vestibular rehabilitation along with spinal manipulative therapy was initiated. Therapeutic exercises such as gait training, postural stability and weight shifting exercises were performed to develop strength and endurance in the lower extremities. Also, cross crawls and left complex movements on the upper and lower extremities were used to improve balance, coordination, kinesthetic sense, posture and proprioception. Passive vertical and horizontal gaze stabilization exercises and sound and light stimulation were used in the left lower visual field. Repetitive peripheral sensory stimulation (RPSS) over the three branches of the trigeminal nerve bilaterally were also included in treatment. Spinal manipulative therapy, cervical traction and post isometric relaxation (PIR) techniques were implemented to improve range of motion of the spine and strengthen and improve flexibility of the neck muscles and ligaments. Results: After 14 treatment visits, re-evaluation showed decrease in symptomatology and objective data. Patient reported a decrease in intensity and frequency of imbalance and dizziness. Neck pain with radiculopathy was resolved. Average sway index decreased to 2.11 and COG was centered. Balance testing on a perturbed surface with eyes closed showed a decrease index by 2 standard deviations. Eye movements testing showed a decrease in frequency of square wave jerks and saccadic intrusions, and patient was able to hold gaze without fatiguing. VOR with fixation improved bilaterally, showing no nystagmus on head thrust testing. Right facial hypersensitivity was resolved. Deep tendon reflexes demonstrated a grade +2 in biceps, triceps, patella and achilles tendons. Conclusion: There are potential benefits when using chiropractic neurology treatment to improve vestibulo-cerebellar function in patients suffering from imbalance and dizziness. Further studies are warranted to explore the efficacy of chiropractic neurology treatments on patients with this symptomatology.

Keywords: Dizziness, Imbalance, Chiropractic, Neurorehabilitation, Cerebellum

Conference: International Symposium on Clinical Neuroscience 2018, Orlando, Florida, United States, 24 May - 26 May, 2018.

Presentation Type: Poster

Topic: Clinical Applications in health, disease, and injury to the nervous system

Citation: Soto V, Jimenez C and Esposito SE (2018). Improvement of vestibulo-cerebellar function in patient with symptoms of dizziness and imbalance following chiropractic neurology treatments. Front. Neurol. Conference Abstract: International Symposium on Clinical Neuroscience 2018. doi: 10.3389/conf.fneur.2018.60.00126

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Received: 05 Apr 2018; Published Online: 14 Dec 2018.

* Correspondence: Dr. Susan E Esposito, Life University, Marietta, United States, susanesposito@gmail.com